The Dr. Hyman Show - Treating Acne From The Inside Out with Dr. Elizabeth Boham

Episode Date: May 29, 2020

Treating Acne From The Inside Out with Dr. Elizabeth Boham | This episode is sponsored by AirDoctor Acne is the #1 skin condition in the United States, affecting not just millions of teenagers but an increasing number of adults as well. We spend over a billion dollars for prescriptions and over-the-counter (OTC) products to cure acne, yet at best these are short-term solutions. Conventional medicine deals with symptoms, so their solutions for acne include lathering on potions and lotions, and taking antibiotics or strong liver-damaging medications. Functional Medicine, on the other hand, addresses the problem’s root cause. From this lens, we can understand that numerous factors contribute to acne, including nutritional status, stress, toxicity, inflammation and hormonal and gut imbalances. In this mini-episode, Dr. Hyman is joined by Dr. Elizabeth Boham to discuss the Functional Medicine approach to treating acne and other skin issues. Dr. Elizabeth Boham is a physician and nutritionist who practices Functional Medicine as part of my team at The UltraWellness Center in Lenox, MA. Through her practice and lecturing, she has helped thousands of people achieve their wellness goals. She is part of the faculty of the Institute for Functional Medicine and has been featured on the Dr. Oz show and in a variety of publications and media including Huffington Post, The Chalkboard Magazine, and Experience Life. Her DVD Breast Wellness: Tools to Prevent and Heal from Breast Cancer explores the Functional Medicine approach to keeping your breasts and whole body well, a topic she is passionate about as a breast cancer survivor. In this episode, Dr. Hyman and Dr. Boham discuss: Why what you’re eating is so much more important than what you put on your skin How topical skin treatments can work in short term but cause issues in the long term  Foods that can commonly cause acne, including sugar, starch, dairy, and processed foods How sugar affects our microbiome and immune system How Dr. Boham treated two patients with acne  The gut-skin connection Nutrients that are really important for skin to turn over, including vitamin A and zinc How toxins such as pesticides and BPA can affect skin and overall health   Supporting your detoxification system through diet, hydration, sweat, and more For more information, visit drhyman.com/uwc This episode is sponsored by AirDoctor. We need clean air not only to live but to create vibrant health and protect ourselves and loved ones from toxin exposure and disease. Learn more about the AirDoctor Professional Air Purifier system at a special price at www.drhyman.com/filter Additional resources: “Got Acne? What You Put IN Your Body is More Important Than What You Put on Your Skin” https://www.ultrawellnesscenter.com/2019/08/01/got-acne-what-you-put-in-your-body-is-more-important-than-what-you-put-on-your-skin/ “Inner Glow” https://www.ultrawellnesscenter.com/2017/07/17/inner-glow/ “Hormones and Neurotransmitters” https://www.ultrawellnesscenter.com/2012/10/17/lesson-3-hormones-and-neurotransmitters/ “Gut and Digestive Health” https://www.ultrawellnesscenter.com/2012/10/17/lesson-4-gut-digestive-health/ “Detoxification” https://www.ultrawellnesscenter.com/2012/10/17/lesson-5-detoxification/ “Energy, Mitochondria and Oxidative Stress” https://www.ultrawellnesscenter.com/2012/10/17/lesson-6-energy-mitochondria-oxidative-stress/ “Clean Beauty” https://www.ultrawellnesscenter.com/2019/04/25/clean-beauty/ “Why Is Sugar So Hard To Kick” https://www.ultrawellnesscenter.com/2018/08/15/why-is-sugar-so-hard-to-kick/ “Essential Glutathione: The Mother of All Antioxidants” https://drhyman.com/blog/2010/05/19/glutathione-the-mother-of-all-antioxidants/ “Defeating Acne, Quick Meal Prep, and How to Gain Weight on a Low Carb Diet” https://drhyman.com/blog/2017/04/17/defeating-acne-quick-meal-prep-gain-weight-low-carb-diet/ “10 Simple Strategies to Eliminate Acne” https://drhyman.com/blog/2015/11/04/10-simple-strategies-to-eliminate-acne/ “Do Milk and Sugar Cause Acne” https://drhyman.com/blog/2011/02/11/do-milk-and-sugar-cause-acne/ “How to Feed the Gut” https://drhyman.com/blog/2018/04/13/how-to-feed-your-gut/ “Get These Toxins Out of Your House: https://drhyman.com/blog/2016/07/25/get-these-toxins-out-of-your-house/ “Enhance Detoxification” https://drhyman.com/blog/2010/08/30/the-ultramind-solution-key-5-enhance-detoxification/ “EWG’s 5 Ways to Reduce Your Exposure to Toxic BPA” https://www.ewg.org/news-and-analysis/2018/02/5-ways-reduce-your-exposure-toxic-bpa Hosted on Acast. See acast.com/privacy for more information.

Coming up on this episode of The Doctor's Pharmacy. The food that you're putting in your mouth is so much more important than what topical things you're putting on your skin. Welcome to a special episode of The Doctor's Pharmacy called House Call. I'm Dr. Mark Hyman and that's pharmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. And you're going to learn about some important topics that affect millions and millions of people in this country. And it's something that we all wish we would never get, which is pimples. We have a massive acne epidemic in this country.

It affects over 50 million people, which is no small amount of people. That's more people that have diabetes or cancer or heart disease. And it's something that's incredibly treatable using the principles of functional medicine. It's the easiest thing to treat almost in functional medicine. And today I'm sitting with my colleague, my friend, my partner at the Ultra Wellness Center, the medical director here, who's an extraordinary physician, a nutritionist, a registered dietitian, exercise physiologist. And she works with us here at the Ultra Wellness Center, leads the team in an

incredible way, which she's been doing for so long. And I'm just so grateful, Liz, to have you on the podcast again and to have your wisdom and help to help people solve this horrible problem called acne. Well, thank you, Mark. Thank you for having me. All right. So tell us a little bit about the scope of this problem and some of the background that we know about how we think about it in traditional medicine and how we approach it versus how we might approach it using a functional medicine approach and how we deal with it here at the Ultra Wellness Center. Absolutely. I mean, acne is the number one skin condition in the United States. So it's the number

one issue that people in the United States are dealing with in terms of their skin. As you mentioned, 50 million Americans are dealing with this. And, you know, we know that it's more common in our, when we're going through puberty, when our hormones are shifting, we often will see acne in the adolescent age group, but we're seeing more and more acne in adults now as well. And, and that is definitely increasing. You know, I remember I was having a conversation with my daughter, you know, about skincare products, you know, and okay, what's the best thing to use for my skin. And all of a sudden I realized, even though we had been, she'd lived with me her whole life, you know, I don't think I ever

said this. I said, what's what you're eating is so much more important than what you're putting on your skin. You know, what the food that you're putting in your mouth is so much more important than what you're, what topical things you're putting on your skin. And so it made us start to have this conversation, which I thought I was saying all the time, but that I think sometimes people don't realize or understand, or the connection is not made, right? That how important what you're choosing to eat every minute of the day, you know, how much that impacts your skin. Yeah. I mean, the traditional medicine focus on the outside in, what stuff you can slather on your face, what creams, potions, lotions, or maybe taking antibiotics, which is a whole problem we're

going to talk about a minute but most of our skin health comes from the inside out yes so if you want great skin if you want glowing skin if you want clear skin if you want to get rid of your acne if you want to get rid of your eczema if you want to get rid of your psoriasis if you want to get rid of you know rosacea all these things come from the inside out and traditional dermatology focuses on the outside in and it doesn't really work that well most of the time, even when you work on the outside in. And it's difficult, it's expensive. These medications are absorbed. You know, you basically, my rule is if you wouldn't eat it, you shouldn't put it on your skin.

And a lot of times with the topical treatments, whether it's, you know, steroids for eczema or topical antibiotics for acne, they can work in the short term, but in the long term, they disrupt, they disrupt your skin and make you more prone to getting it in the future. For example, you know, we know both topical steroids and topical antibiotics are going to get rid of that really important layer of good bacteria that's on our skin. So wait, you have a microbiome on your skin is what you're saying. I know, it's kind of cool, right? Not only in our digestive system, but lining our skin.

And so those medications, though they can be helpful in the short term, in the long term, they're damaging, they're getting rid of all of those good bacteria, which are really important first line of defense. And so then you create a dysbiosis or an imbalance in the good and bad bacteria on your skin. And then that just makes you more prone to getting more acne in the future. So it may be okay in the short term, but it's not getting to that underlying root cause. It's true. And so we put on antibiotics on the skin. We put on these agents that dry it out

like benzoyl peroxide, which are most of these acne products. And if that doesn't work, we give people oral antibiotics, which not only describes the facial microbiome, but also the gut microbiome. And what we know now in functional medicine and in medicine in general, if people paid attention to the research on acne, is a lot of it starts in the gut. So if I see someone with skin problems, the first thing I think of, what's going on in their gut? What's going on with their food that they're eating? With inflammatory foods, with food sensitivities, with foods that trigger hormonal responses, with foods that increase something called insulin resistance. So tell us about the pathology and the pathophysiology of acne, because it's very interesting, because we often just think it's like a topical thing,

but it's really not. Yeah. I mean, one of the things we know with foods is that when you eat foods that are really refined and processed, foods that are high in sugar and refined carbohydrates, you'll get a spike in your blood sugar. And you'll often get that spike in insulin after you get a spike in blood sugar, right? So you eat food, your blood sugar goes up, the body makes a lot of insulin. And that spike in insulin and blood sugar will cause a follicular hyperkeratinosis. Wow, that's a big word. I know, right? Which just means that there's extra, that in the follicles of the skin, the skin's not turning over as well as it should.

And so cells get stuck in the skin. And then those stuck cells can get more inflamed and you can get, acne can get produced. So one of the major things we always start with is pulling away the refined and processed foods and the sugary foods. And starchy foods. And starchy foods. And starchy foods, right? Anything that's going to cause that insulin spike. You can really see signs of insulin resistance on the skin in so many different ways. It's like prediabetes, right? It's like you eat too much sugar, your blood sugar goes up,

your insulin goes up, and it creates this vicious cycle we've talked about so much, which is this prediabetes that affects one out of every two Americans. Yes. Right? Right. And so their insulin is higher than somebody who doesn't have insulin resistance. And that high level of insulin causes a lot of shifts in the skin. It causes that follicular hyperkeratosis that causes the acne. It can cause more skin tags. It can cause something called acanthosis nigricans, which is this darkening of the skin folds like in your neck and in your armpit. And so you can, by just examining somebody right away, you can get a sense of, do they have insulin resistance or that pre-diabetes state? Because

it shifts the growth factors, the high inflammation from eating these high sugary foods causes changes in your skin. We know that, for example, PCOS, which is polycystic ovarian syndrome, it's a common condition that affects women that causes infertility. We're going to talk about that on another podcast. It causes acne. Yes. It causes really screwed up menstrual cycles and it causes hair growth. And we think of it as a ovarian problem.

It's not. It's a mouth problem. It's a mouth problem. It's a fork problem. It's a dietary problem. Often, yeah. Right? And so it's caused by insulin resistance. And the consequences of that are the acne and all these screw up hormones. So when women have a lot of sugar, it actually can increase their testosterone, which causes acne, and it causes hair growth, and it causes infertility. So the treatment isn't heavy-duty drugs and hormones, it's actually changing your diet. Which is amazing to see. I mean,

we know that when we pull away those refined and processed foods and the sugary foods, most of our patients, so many of our patients see great improvement in their acne right away. Right away. Right away. So, so sugar, starch, processed foods, they got to go. Yeah. And then, and then there's another food that is really common in this country. And it is a huge driver of acne. Yeah. The dairy. Yeah. Dairy. Dairy. I mean, cause dairy is, you know, all of our dairy food, our milk, our cheese, our ice cream, you know, all of that is very high in hormones. There's 60 different hormones in milk.

And these are not added like growth hormone. These are just naturally occurring hormones. Why? It's a growth food for calves. It helps the calves grow, right? So it's got a lot of factors that are hormonally active that drive growth. Yes. And we know that those growth factors can stimulate acne in some people.

You know, not everybody, but for some people, they're more sensitive to them and they definitely will cause more acne. Actually, for a lot of people. I'm one of them. If I have dairy, I get pimples. So if I know I'm going on a TV, I can't eat dairy. I don't usually eat dairy, but if I have sheep or goat, it's a little different. It's not as inflammatory for some

reason. But if I have regular dairy, you can count on me getting pimples. And I'm like 60 years old to get pimples from dairy. Absolutely. And I think it depends, like the question of sheep or goat, I think it depends on the person. There's some people that it really, all types of dairy bother their skin. And for other people, there's some that is better than others. And what we know is sometimes the testing, like the food allergy testing or food sensitivity testing doesn't always pick it up. I mean, we do it often, but there are times when we get a negative test result, but even if we still pull it away and people's skin improves.

So this isn't like an allergy necessarily. Not necessarily. It could be just like you said, all the hormones in dairy too. But there's another category of things, which are food sensitivities that do drive inflammation and drive leaky gut and can drive acne that are independent.

So we've got sugar, we've got dairy, and we've got this other category, which is sort of more sort of amorphous, but it is a factor in a lot of people. Absolutely, absolutely. So there's so many ways, and I always say this, there's so many ways that somebody can react to food, right? You can have, and people get confused all the time because they get one negative report and they say, oh, then I must be fine to eat that food, right? You can get an immediate reaction to food or an IgE. You can get

a delayed reaction to food or an IgG, but you can also have a food intolerance. There's just so many ways you can react to food. So just because you have one negative food test result doesn't necessarily mean that food is not causing you problems. That's a whole other topic, which is what are the many ways that we react to food? What are the 50 ways I love you? It's like, what are the 50 ways you react to food? And it's all kinds of stuff from tartrazine and which is a diet that causes asthma. It's an additive or whether it's MSG that can cause a, an amino acid related cognitive effect or whether it's,

you know, or whether it's something like high fructose corn syrup, which people can have fructose intolerance, right. Or how food changes your microbiome. And then that changes the inflammation. I mean, you know, that's a lot. Yeah, and by the way, in this age of COVID and coronavirus,

it's really clear that the more sugar we eat, it affects our immune system, but it also affects our microbiome. And our gut health, it turns out, is incredibly important for us to be resistant to the flu through many, many research studies, and likely to coronavirus as well. Absolutely. Absolutely. And, you know, I think that this, this first case that we were going to talk about this 22 year old who came to see me, you know, she, um, it really kind of pulls in the importance of the microbiome in terms of your immune system, but also in terms of your skin. Right. a 22-year-old and she started to develop acne when she was around 12. When we got more history from her, I realized she had had multiple antibiotics as a

kid. She had chronic ear infections. And especially when she was getting those ear infections, they were treating most of them with antibiotics. And I think we've kind of calmed down a lot on treating every ear infection with antibiotics, but she got a lot of antibiotics because of her ear infections. Yeah. I was a family doctor. Remember, it's like, oh, give me a lot of candy, a little moxicillin. It's like nothing. Right. Right. I'm like horrified by what I did 30 years ago. So she's, you know, she's, she came in to see us because she was using a lot of different topical treatments. She was also taking a low-dose antibiotic.

And her skin was better, but she didn't want to stay on these antibiotics. And she wanted to really look at it a different way. And when she stopped taking the oral antibiotic, which she realized she didn't want to be on forever, her acne started to get worse again. So she said, okay, I really want to figure out. Which is not uncommon. And then doctors say, oh, you need more antibiotics. Right. It's like, that's the vicious cycle. It becomes a vicious cycle. We see these vicious cycles all the time with medications,

right? Because they're shifting, because there's antibiotics, as we've mentioned, are shifting the microbiome. They're shifting the microbiome in your gut. They're shifting it on your skin. They're getting rid of that first line of defense. And then they're allowing, then it's more common to get the acne again when you stop them. And so just because of her history of all of those antibiotics as a kid and being on the antibiotics, and because we got more information, she was having a lot of digestive issues. She was having some bloating, some diarrhea, constipation. Her digestion was off. And your dermatologist was never like, what's going on with your gut, right?

No, right. No, he didn't ask that. So because of that, I said, you know what? I really need to focus on the microbiome here for this woman to help improve her acne. And so we did a stool test, which is kind of a neat, it's a neat way to get a sense of what's going on in the microbiome. It looks for real- How is this different than like what a traditional doctor would do with a regular stool test? You know, it just, it looks at a lot of different biomarkers, right? So it's looking at all of your levels of commensal bacteria, like all the good bacteria, and is there an imbalance in the good and bad bacteria? So it does look for acute

infections, for real infections as well, but it also is really paying attention to something we call dysbiosis, which is an imbalance in the good and bad bacteria, and trying to get a sense of, is there an overgrowth of not good bacteria or not good yeast? Or it also looks at parasites. It looks at digestion and absorption and inflammatory markers. Yeah, so you look at how your enzymes are working and are you digesting your food or you're absorbing your food? Is there inflammation in there?

It's like a window into a dark world, you know, and we can learn so much from that through these tests, which are really not available through traditional doctors. I mean, they could order them if they wanted to, but they just, it's just not something we're trained in, which is how do we take a deep look in the gutter? We're talking about the microbiome, microbiome, but you know, as some future state of medicine will somehow figure out what to do with it. Well, we've been doing this for 30 years in functional medicine. And now that we understand even more than we ever did, and we're learning better and better on how to actually optimize the microbiome and fix the problems of leaky gut and all these things that happen as a result of like your patient who had all these

antibiotics and this crappy diet and developed, you know, overgrowth of bacteria that you found and yeast. Right. So when the stool test came back, we found that there was this overgrowth of unwanted bacteria and there was an overgrowth of unwanted yeast. And yeah. And so we can do tests like you said on, is there increased intestinal permeability or leaky gut? And she of course had that because of these imbalances and the inflammation going on in her digestive system. Cause we know that those imbalances cause inflammation. And we know inflammation causes all sorts of things, including acne, right? So we said, okay, we need to work to fix, we need to work to fix this imbalance. Let's work to rebalance the bacteria in her gut. And so

for her, she wanted to use an herbal approach, and I agreed with that. So we put her on a combination of a couple different herbs that can work to get rid of the overgrowth of bacteria and yeast. And that worked really well. The one thing I always say about skin though is you kind of have to be patient sometimes. So if you are pulling away a food like dairy, which we did with her. We took her off of dairy. We took away a lot of added sugar. If you're adding in something to treat the dysbiosis, and we also gave her a lot of probiotics too, you got to give it some time for the skin to improve. You might see some improvement in the inflammatory acne right away, but for the skin to really improve, it takes like six weeks for the skin to turn over.

So you wanna give it some, we always give it some time to say, okay, how is this improving? And so, and we also added in some nutrients that are really important for skin turnover. So we know that zinc and vitamin A are really critical nutrients to help the skin turn over. So you don't get so much of that hyperkeratinosis, that elevated levels of

the skin not turning over, which can cause more acne to develop. And Accutane is a derivative of vitamin A, which is actually what is used for really bad acne. And by using this comprehensive approach, we use in functional medicine that we do here at the Ultra Wellness Center, with the deep diagnostics we do, and knowing how to optimize function of your skin, of your gut, et cetera, we can get people better where often they don't get better. And do it in a way that not only improves their skin, but improves their overall health. Yeah. So very powerful. So we put her on some zinc and vitamin A. Now, the both of those, I just want to caution listeners, if you're not working with a doctor, both of those you can get too much of, and

they can cause imbalances in other vitamins. And vitamin A is fat soluble. So you have to, if you're going to use a higher dose- You can't OD on it. Yeah. Like I use 10,000. I use per day with her. A vitamin A.

A vitamin A. But you don't want to be on that for like a long, long time. No. We did it for like three months and then we started to spread it out. And I was monitoring her levels. And the same thing with zinc. You know, you just have to be a little bit cautious of just taking a lot of this on your own because it can throw off some of your vitamin levels or vitamin A can be toxic at high doses. But it really helped. I mean, the whole comprehensive approach really helped her

skin improve. And she was able to stop using both the oral antibiotics and the topical antibiotics. She was able to get off of them. And her skin, that dysbiosis started to rebalance and she wasn't getting all the acne all the time. And I bet there were a lot of great side effects too. I bet she lost weight and had more energy and felt better, right? Absolutely. Yeah, instead of the side effects being all bad, they're all good. That's true.

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doctor's pharmacy listeners the best deal yet on this amazing filtration system. Right now, if you go to drhyman.com forward slash filter to access the Air Doctor filter for $329, and that's $300 off the normal price of this filter. And this is their biggest deal yet. You definitely want to take advantage. So head over to drhyman.com forward slash filter to access the DL. Thanks for tuning in. Just to recap, this is a really important case because it's a story we hear over and over and over again. You see someone who early on had probably sensitivities to food or maybe had antibiotics for an ear infection. And then it's this vicious cycle of things that disrupt the gut that then lead to sort of secondary problems down the road like acne. And it lead to imbalances

in the microbiome that can get treated with more antibiotics. And you're in this vicious loop and functional medicine takes you out of that loop. And we do a very deep history and we look at also tests, which are really different from what your traditional doctor will do. Food sensitivity testing, stool testing. We look at nutrient levels. We can look at vitamin A, zinc, fish oil, omega-3s that are really important. And then we have a comprehensive approach, which is dietary. We take people off food sensitivity, like dairy, which is a trigger, sugar and starch, maybe other foods. Gluten can be an issue for some people. And then we rebalance the gut. I call it the weeding, seeding and feeding program. We weed out the bad guys. We seed with the good guys, the probiotics.

We feed them, right, which is with prebiotics and the right nutrients, like you said, for the gut healing. And we see these remarkable turnarounds in a very short time. And it's not that hard. It's just you have to know what to do. So it reminds me of that joke where this doctor sent his patient a bill for taking his appendix out. And the patient got the bill.

It said it was $1,000. And the patient writes back to the doctor, he says, doctor, that's a lot of money for such a simple operation. He's like, you're right. He sends him a new bill, says taking out your appendix, $1. Knowing that's what needs to be taken out, $999. And I think that's sort of the key of functional medicine. It's not necessarily that hard.

It's just knowing what to do and what questions to ask and what tests to do and what treatments to apply. Because everybody's an individual, right? I mean, I think that's so key, right? So we're all individuals. So that for that patient, it was her microbiome that we needed to rebalance. But for the next person we're going to talk about, it's going to be how do we help support

their detoxification system? And for somebody else, it may be just as simple as they're eating too much sugar, you know, and, but, but it's, but I think it's important that we have to recognize that we're all an individual, we're all individuals and the cause of acne is not just one problem. It's, it depends on your individual story, how we treat it. You know, we often say medicine that, you know, one disease can have many causes and one cause can create many diseases. So acne can have many, many different things. There are common patterns. And there are common patterns.

So we know what to look for. But in each individual, it might be a little bit different. And that's what we call personalized medicine, precision medicine, personalized nutrition, precision nutrition, personalized health, precision health. It's what we do. That's what functional medicine is. Tell us about the next one because it's quite a different kind of case that you wouldn't expect that would relate to acne, right? Right.

So she was a 44-year-old woman, and she had been struggling with acne her whole life. It got worse definitely before her period. So it was a hormonal connection. But she always had some acne. And we did an elimination diet with her. She had tried some on her own. But then when she came to see us, we became more strict and we pulled away really more inflammatory foods just to see.

We did some testing and we pulled away gluten and dairy and all the sugars and refined products. And her skin got a little bit better, but only a little bit better. And we did some of the stool testing on her and it looked pretty good. So I started to think, okay, we've got to look a little deeper here. And so we did some evaluation on her toxic load, right? We started to look at her, how she metabolized her hormones. We started to look at what levels of toxins she had in her body. We looked at things like the pesticide levels. We looked at BPA levels. We looked at-

What's BPA? BPA is a bisphenol A. Sorry. What are you using? I'm sorry. Where do people get that from? From the hard plastic. Yeah, hard plastic.

Also your credit card receipts, your ATM receipts, your- Lining of cans. Your receipts from your gas station, lining of cans. Lining of cans. I never, people say, you want a receipt? I'm like, nope. Yeah, no, I always say no. I always say no.

And then, you know, in a lot of the big containers of water that people get, those are BPA containing containers. So, you know, you want to be drinking out of glass and- Metal. Metal, not plastic, right? But that can act as a xenoestrogen. So it can act as an estrogen in the body. So- So what's interesting, you just said something powerful. I want to just stop for a minute, because most people don't realize, I think these toxins are poisons. They get that. But they don't realize that the way they act in the body is hormonal.

They're hormonal imposters, mimics. In fact. And there's a book I read years ago called Our Stolen Future by Theo Colburn, where she documented the ways in which all these environmental chemicals were affecting the reproductive health of animals and humans. It was just fascinating to me. And it was just like, whoa, people really want to learn about this. They should check out that book. But tell us more about how that works. So they realized that BPA was an issue back in the 1970s, I think, at Tufts University,

where they were doing research on breast cancer. And then they realized that the test tube was impacting their results. And then they were like, okay, we've got to figure out what's in the test tube. And that's when they realized the BPA can act like estrogen in the test tube and impact the growth of cancer that they were evaluating or studying. And that's when we started to learn more about BPA and how it can act as a xenoestrogen

or it is a xenoestrogen, which can bind to the estrogen receptor in your body and then shift your hormones. What's so fascinating about these xenoestrogens or xenohormones is, I mean, xeno means foreign, right? Is that they're in small concentrations, but it turns out that they're synergistic. So we might get a little BPA here and a little phthalate there and a little whatever there. And they're not one plus one equals two, they're one plus times one equals a thousand. And so in very small amounts, they're extremely potent and they bind to the receptors. They can activate them. They link to cancer. They're linked

to insulin resistance and obesity. So BPA can cause obesity and insulin resistance. So you get these double mechanisms of insulin resistance, of hormonal disruption, and this can cause all kinds of problems, including acne. Yeah. And so what I realized with all of her testing is that she had a high toxic load, just what you're saying. She had a little too high of lead and mercury. Her BPA was high. Some of her pesticide levels were high. And she had a high level of oxidative stress. So oxidative stress is a marker. There's multiple different markers of oxidative stress. Yeah, there are excessive free radicals in the body. So when you don't have enough antioxidants, or if your body is producing too many pro-oxidants because of poor diet or toxins,

you get this imbalance, right? You don't have enough of the good antioxidants to get rid of too many of the pro-oxidants that are being formed. You get an imbalance called oxidative stress and we can measure that. And we can see it like it's something people know when your apple turns brown, that's air and oxygen interacting or a car rust, right? Or your skin wrinkles from the sun. That's all oxidative stress, but it's happening on the inside. Yes. And you know, we always make these free radicals, but the problem is when you make too many

or you don't have enough of the antioxidants or those phytonutrients to get rid of all the too many antioxidants. And so you can measure that imbalance. You can look at markers of oxidative stress in somebody's body, which is associated with aging and illness. That's an unusual test we do in functional medicine. We do here at the Ultra Wellness Center that you normally wouldn't get that tells you sort of what's going on. And it's a great way. I think it's one of the best biomarkers to look at to see

how is somebody improving, right? And so for her, she had this elevated level of oxidative stress. And I'm like, well, that's interesting. And so then we started, that's when we looked at all these toxins because they can be a cause of oxidative stress. There's multiple causes, but these can be one of them. And so I realized she had this elevated toxic load. She had some genes that made it harder for her to produce glutathione, which is this amazing antioxidant for the body. And that's the other thing we do here. We do testing that looks at genes. Now, we don't do your entire genome sequence, which is a thousand bucks, but we look at very specific genes that are common, that we can do something about, that have some kind of clinical relevance,

and that we can modify through diet, lifestyle, supplements, reducing toxic load, whatever. And what were the things you found in her? Right. So she had a couple of variations in some of her glutathione genes. Her glutathione genes, the GSTM1 gene that helps the body with production of glutathione. What is glutathione? Glutathione is this amazing antioxidant and detoxifier in the body. And so she genetically had a harder time with production and utilization of her glutathione.

By the way, I wrote an article years ago. It's called The Mother of All Antioxidants, Glutathione. So if you want to learn more about it, you can check that out. And you know it, and it's still so relevant and so important. We know that glutathione is critical for a well-working immune system. We know it's critical for helping your body detoxify. And there's some of us that have some variations in our genes that make it a little harder for us to make and produce glutathione.

And I'm one of them. And that's why I got mercury toxicity. And that's maybe why you got breast cancer, right? Yeah. So, but you know, there are things we can all do. So there's a lot of people with these genetic variations. Half the population. Yeah.

So it's not like it's a rare thing. But there are things we can do to help our body make more glutathione. And one of those things is eating a lot of cruciferous vegetables, the broccoli, cauliflower, cabbage, radish, kale, right? All those great cruciferous vegetables that help the body with production of glutathione. We can also give things like N-acetylcysteine or NAC, which helps the body make glutathione. And for her... It turns out that may be helpful in coronavirus and COVID-19, the N-acetylcysteine,

because it helps with the antioxidant protection and with glutathione production, which is really important as an anti-inflammatory, as well as a detoxifier and antioxidant. Yeah. And there's been some studies that it can work as an antiviral and it's got some good lung effects. So it's really an interesting nutrient. It's actually what we give people who have terrible lung asthma symptoms. We literally can give them inhaled mucomyst, right? Yes, NAC. It's actually N-acetylcysteine.

When we were working as doctors, I mean, I was in the emergency room. I didn't know it was a supplement. I thought it was a drug because it was called mucomyst and you'd order it and people would get this inhaled N-acetylcysteine for their respiratory issues. Yeah, yeah. And the sulfur-containing vegetables, onions, garlic, shallots, those things are really important to help the body make glutathione. And then we actually just gave her glutathione.

I gave her this liposomal glutathione. You can squirt it in your mouth. It gets absorbed through the cheek. You can also give IV glutathione. You can squirt it in your mouth. It gets absorbed through the cheek. You can also give IV glutathione. We do that here also at the Ultra Wellness Center. There's other IVs that we do for the skin too, which is kind of interesting, zinc and B vitamins. But what was great was that's really what helped her skin improve. It was really focusing.

Of course, we did the good diet and the good microbiome protection, but really helping her with her detoxification. Decrease her total body load of toxins. Exactly. Decreasing her total body load of toxins and helping her body detoxify. That also helped her body detoxify her hormones and metabolize her hormones. You always focus on those good things with detoxification too, right? Like drinking lots of water, having regular bowel movements, eating a lot of fiber, sweating, exercise movement, sauna. Yeah. All help the body detoxify. But for

her, that's when we started to see improvement in her skin. So this is like, seems like a really different kind of approach than you'd get at your doctor. You go in and you go, well, here's, I've acne, take this stuff, put it on your skin. You're saying, wait a minute, what could be the cause? The typical things aren't working, dairy and sugar elimination. So you went deeper, you go, well, I have acne. Take this stuff, put it on your skin. You're saying, wait a minute, what could be the cause? The typical things aren't working, dairy and sugar elimination. So you went deeper and you said, well, maybe there's environmental toxins. So you looked at tests that helped her identify what was going on. Heavy metals, petrochemical byproducts. We call persistent organic pollutants, BPA and pesticides.

And then you helped her with diet to actually upregulate these pathways that actually helped her detoxify. You reduced her load by identifying where these sources were in her environment, her diet, and her lifestyle, and got rid of those. And the Environmental Working Group, or ewg.org, has a great list of resources of how you reduce your exposures, whether it's household cleaning products, skin products, your diet, vegetables, animal products, whatever you're doing, how do you reduce your body burden of toxins? And then you gave her certain supplements that helped to upregulate the bright pathways. And the result was her acne got better. It's phenomenal.

Now that is such a different approach you wouldn't normally see when you go to the doctor and dermatologist and they have pimples, right? Yeah, because I mean, I think that the way that we're trained in conventional medicine, right, is to quickly identify and then find the medication to suppress the illness or the symptoms, right? And we all know that works well in acute care, right? When somebody has an acute issue, you want to be able to quickly identify and suppress the issue. But with chronic issues, we know that that way of treating is not the best. But that's how we were all trained in conventional medicine. You were trained with that same model. So we have to work to change that because we know for chronic issues and things even like acne, it's not getting to that underlying

root cause. See, that's the thing, that the doctor gives you a label. Say, oh, you've got these little white things on your face or it's inflamed. I know what you got. You got acne. But acne isn't the cause of the problem. It's the name of the problem. Yes. So in functional medicine, we focus on the cause, not just the name.

Absolutely. And it's important to know what it is. But, you know, acne rosacea is another kind of acne, which is really problematic. A lot of people have it. It's like where they get red nose and red face. And that often is treated in a similar way. The gut is a huge factor. It's such a huge factor, the gut.

I mean, I have patients where it's dysbiosis until proven otherwise. I mean, you see so much of it is dysbiosis. And we treat the dysbiosis, the acne rosacea gets better. And when it starts to come back, we go, okay, that dysbiosis is coming back. So Liz, this is an incredible podcast. I think it's going to help so many people who suffer with skin problems, not just acne, but like all skin problems. And we talked about some other ones on other podcasts, but you know, this is the problem that affects 50 million people. And like I said, that's more people that have cancer, diabetes, and heart disease, right? Autoimmune disease affects more people, but that means all the

autoimmune disease. So this is such a common issue. It's so poorly treated with traditional medicine in ways that are actually harmful, like oral antibiotics or Accutane can be hard on the liver. And that it's relatively simple to treat using functional medicine, using a different set of questions, a different set of tests, a different set of dietary interventions, specific supplements that can help. And we talked about things like zinc and vitamin A,

fish oil, evening primrose oil is another one that's great. So it's just such a refreshing story to hear of these patients who recovered from a problem that creates so much problem for people. It creates so much emotional distress. It creates so much psychological distress. And it's just a pain to have pimples. So I just really grateful for the work you do and work we do here at the Ultra Wellness Center to bring these kinds of approaches to so many people who really are struggling with these issues. And we provide a real simple way for people to access this. And people can go to ultrawellnesscenter.com,

learn more about our practice. They can click on the Get Started tab to actually register to become a patient. And I think that if we just go that little bit extra and a little bit more sort of thorough, comprehensive evaluation based on this new model of functional medicine, which is treating the cause and treating the system, not just the symptoms, we can help so many people. So Liz, thank you so much for joining us on the Doctors Pharmacy special episode of The House Call. And if you've been listening to this podcast and you love what you heard, please share with your friends and family on social media, leave a comment. I'd love to hear from you and subscribe wherever you get your podcasts. And we'll see you next time on The Doctor's Pharmacy. Thank you, Mark.

Hey, everybody. It's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health and I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else, I promise, and all you do is go to drhyman.com forward slash PICS to sign up.

That's drhyman.com forward slash PICS, P-I-C-K-S, and sign up for the newsletter, and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical

professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.